Background: Child malnutrition is a major public health problem in Ethiopia. Surprisingly, the highest level of stunting is found in food surplus areas of the country. Objective: To identify the determinants of stunting in food surplus areas of West Gojam Zone. Method: A community based cross-sectional survey was conducted on 622 mother-child pairs of 0-59 month old children in Mecha and Wenberma Woredas of West Gojam Zone, Northern Ethiopia between May and June 2006. The study investigated the differential impact of demographic and socio-economic factors, health related factors and dietary factors on stunting among under-five children. Both bivariate analysis and multivariate analysis (logistic regression model) were used to identify the determinants of under-five stunting. Results: The analyses revealed that 43.2 (12.0-17.6) 95% CI percent of the children under age five were suffering from chronic malnutrition, 14.8 (39.3-47.1) 95% CI percent were acutely malnourished and 49.2 (45.3-53.1) 95% CI percent were found to be under-weight. The main contributing factors for under-five stunting were found to be sex of the child, child's age, diarrhea episode, deprivation of colostrum, duration of breastfeeding, pre-lacteal feeds, type of food, age of introduction of complementary feeding and method of feeding. Conclusion:The findings of this study led to the realization that inappropriate feeding practice is the principal risk factor which brought about nutritional deprivation among under-five children in food surplus areas of Ethiopia. Thus, the importance of appropriate feeding during infancy and childhood cannot be overstated even in food surplus areas. The high prevalence of malnutrition in the study area points out the need to revisit the impression held by many people that malnutrition is not a problem in food surplus areas. Development and implementation of preventive policies aimed at addressing child malnutrition should also consider food surplus areas of the country. [Ethiop. J. Health Dev. 2009;23(2):98-106]

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Despite poverty reduction and increased promotion of improved nutrition practices in the community, undernutrition in Ethiopia remains a concern. The present study aimed to explore the demand and supply side barriers that limit the uptake of nutrition services among pregnant women from the rural communities of the Tigray Region, Northern Ethiopia. A community-based qualitative study was conducted in December through January 2017. A total of 90 key informant in-depth interviews and 14 focus group discussions were undertaken. Study participants were purposively selected for specific characteristics, along with health professionals deployed at various levels of the health system, including health posts, health centers, woreda health offices, and the regional health bureau. Study participants were asked to identify the barriers and implementation challenges that limit access to nutrition services for pregnant women. Participants’ responses were transcribed verbatim, without editing the grammar, to avoid losing meaning. The data were imported to ATLAS.ti 7 (qualitative data analysis software) for coding and analyzed using a thematic content analysis approach. The study findings indicated that the dietary quality of pregnant women in the study area remains poor and in some cases, poorer quality than pre-pregnancy. Across study sites, heavy workloads, food taboos and avoidances, low husband support, lack of economic resources, lack of awareness, low educational level of women, poor dietary habits, increased expenditure for cultural and religious festivities, “dependency syndrome”, low physical access to health facilities, poorly equipped health facilities, focus on child health and nutrition, poor coordination among nutrition specific and sensitive sectors, and limited sources of nutrition information were identified as the demand and supply side barriers limiting the uptake of nutrition services during pregnancy. In conclusion, the community would benefit from improved social behavior change communication on nutrition during pregnancy and multi-sectoral coordination among nutrition-specific and nutrition-sensitive sectors.

The prevalence of stunting in Sub-Saharan Africa has changed little since 2000, and the number of stunted children has increased. In contrast, Ethiopia is an example where the national stunting prevalence and number of stunted children have decreased consistently. We compare regional differences and temporal patterns in stunting with large-scale program coverage to identify where and when programs may have led to reductions in stunting. Data from three national demographic and health surveys and population statistics illustrate, at the regional level, where and when the prevalence and number of stunted children changed since 2000. Reports from large-scale nutrition and health programs were used to identify ecologic associations between geographic program coverage and reductions in stunting. From 2000 to 2005, the decline in the national stunting prevalence was mainly a result of reductions in Oromiya, SNNP and Tigray. Few nutrition programs had high coverage during this time, and economic growth may have contributed to stunting reduction by increasing household wealth and investments in sanitation. From 2005 to 2011, declines in stunting prevalence in Amhara, SNNP, Somali and Oromiya were largely responsible for national reductions. Numerous programs were implemented at scale and could have plausibly improved stunting. While ecologic relationships suggest that economic growth and large-scale programs may have contributed to the reduction in stunting in Ethiopia, stunting did not decrease in all regions despite increased program coverage expansion of the health system. Additional impact evaluations are needed identify the most effective programs to accelerate the reduction in the prevalence and number of stunted children. © 2016 John Wiley & Sons Ltd.